Potassium Chlor 20% Liq(40meq/15ml)
It is used to treat or prevent low potassium levels.
Drug Class
Electrolyte replacement; Potassium supplement
Pharmacologic Class
Electrolyte
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Potassium chloride is a medicine used to treat or prevent low potassium levels in your body. Potassium is a very important mineral that helps your heart, muscles, and nerves work properly. This liquid form needs to be mixed with water or juice before you drink it.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication with or immediately after a meal. Prepare the mixture as directed by mixing it with water, then drink it slowly. It's essential to consume the mixture right away and not save it for later use.
Storing and Disposing of Your Medication
Store your medication at room temperature, away from light and moisture. Keep it in a dry place, avoiding storage in a bathroom. Do not freeze your medication. Always keep your medications in a safe location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication with or immediately after a meal. Prepare the mixture as directed by mixing it with water, then drink it slowly. It's essential to consume the mixture right away and not save it for later use.
Storing and Disposing of Your Medication
Store your medication at room temperature, away from light and moisture. Keep it in a dry place, avoiding storage in a bathroom. Do not freeze your medication. Always keep your medications in a safe location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Always dilute the liquid potassium chloride in at least 4 ounces (120 mL) of water or juice before taking it to prevent irritation of the stomach and esophagus.
- Take with food or immediately after a meal to minimize stomach upset.
- Do not chew or crush extended-release tablets if you are prescribed that form.
- Do not use salt substitutes that contain potassium unless directed by your doctor.
- Report any signs of muscle weakness, tingling, or irregular heartbeat to your doctor immediately.
Available Forms & Alternatives
Available Strengths:
- Potassium Cl 2meq/ml Inj 30ml
- Kcl/d5w/nacl 0.15/0.9 Inj , 1000ml
- Kcl/d5w/nacl .15/.45% Inj, 1000ml
- Potassium Cl 2meq/ml Inj 20ml
- Potassium Cl 2meq/ml Inj 10ml
- Potassium Cl 2meq/ml Inj 20ml
- Pot Chl/nacl 0.15/.45% Inj, 1000ml
- Kcl/d5w/lr 0.15% Inj, 1000ml
- Pot Chloride 20meq Inj, 100ml
- Kcl/d5w/nacl 0.3/0.45 Inj, 1000ml
- Kcl/d5w/nacl .075/.45 Inj, 1000ml
- Kcl/d5w/nacl 0.15/0.2 Inj, 1000ml
- Pot Chl/dextrose 5%/nacl0.45% Inj
- Potassium Chloride ER 8meq Tablets
- Potassium Cl 10meq ER Tablets
- Potassium Chloride ER 8meq ER Tabs
- Potassium Cl 10meq ER Capsules
- Potassium Chlor 10% Liq(20meq/15ml)
- Potassium Chlor 20% Liq(40meq/15ml)
- Potassium Cl Micro 10meq ER Tabs
- Pot Chloride 8meq CR Capsules
- Potassium Chloride 20meq Powder Pkt
- Potassium Cl Micro 10meq ER Tabs
- Potassium Cit ER 1620mg (15meq) Tab
- Potassium Cl Micro 10meq ER Tabs
- Potassium Chl 40meq Inj, 100ml
- Potassium Chloride 10meq Inj, 50ml
- Potassium Chloride 20meq Inj, 50ml
- Potassium Chloride 10meq ER Tablets
- Kcl/d5w/lact 20meq/l Inj, 1000ml
- Potassium Chloride 20meq ER Tablets
- Potassium Cl 20meq ER Tablets
- Potassium Chloride 20meqpowder Pkt
- Potassium Cl 2meq/ml Inj 250ml
- Potassium Cl 2meq/ml Inj 50ml
- Potassium Chl 10meq Inj,100ml
- Pot Chl/nacl 40meq/l Inj, 1000ml
- Pot Chl/d5w 20meq/l Inj, 1000ml
- Pot Chl/d5w 10meq/l Inj, 1000ml
- Potassium Chlor/nacl 20meq/l Inj
- Potassium Chloride 15meq ER Tabs
Dosing & Administration
Adult Dosing
Standard Dose:
20-40 mEq/day in 1-2 divided doses for prevention; 40-100 mEq/day in 2-5 divided doses for treatment of hypokalemia
Dose Range:
20 - 100 mg
Condition-Specific Dosing:
hypokalemia_prevention:
20 mEq/day
mild_hypokalemia:
20-40 mEq/day
moderate_to_severe_hypokalemia:
40-100 mEq/day (oral, up to 20 mEq/dose)
Pediatric Dosing
Neonatal:
Not established (use caution, consult specialist)
Infant:
2-3 mEq/kg/day in divided doses (max 1 mEq/kg/dose or 40 mEq/day)
Child:
2-3 mEq/kg/day in divided doses (max 1 mEq/kg/dose or 40 mEq/day); for severe hypokalemia, up to 5-10 mEq/kg/day (max 200 mEq/day)
Adolescent:
Same as adult dosing, generally 20-40 mEq/day for prevention, 40-100 mEq/day for treatment
Dose Adjustments
Renal Impairment:
Mild:
Use with caution, monitor serum potassium closely.
Moderate:
Reduce dose significantly or avoid. Monitor serum potassium and renal function frequently.
Severe:
Contraindicated (e.g., GFR < 30 mL/min) due to high risk of hyperkalemia.
Dialysis:
Generally contraindicated. Potassium levels are managed by dialysis. Supplementation only if specifically indicated and under strict monitoring.
Hepatic Impairment:
Mild:
No specific adjustment needed, but monitor renal function as hepatic impairment can affect renal perfusion.
Moderate:
No specific adjustment needed, but monitor renal function as hepatic impairment can affect renal perfusion.
Severe:
No specific adjustment needed, but monitor renal function as hepatic impairment can affect renal perfusion.
Pharmacology
Mechanism of Action
Potassium is the major intracellular cation and is essential for the maintenance of acid-base balance, isotonicity, and electrodynamic characteristics of the cell. It is involved in many enzymatic reactions and plays a vital role in physiological processes such as nerve impulse transmission, contraction of cardiac, skeletal, and smooth muscle, and maintenance of normal renal function. Potassium chloride provides potassium ions to replenish depleted stores and chloride ions to correct hypochloremic alkalosis.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 90% (oral)
Tmax:
1-2 hours
FoodEffect:
Food may delay absorption but does not significantly affect the extent of absorption; taking with food can reduce GI upset.
Distribution:
Vd:
Approximately 0.5 L/kg (reflects total body water)
ProteinBinding:
Not protein bound
CnssPenetration:
Limited
Elimination:
HalfLife:
Not applicable (homeostatically regulated, but renal excretion is rapid)
Clearance:
Primarily renal excretion, varies with renal function
ExcretionRoute:
Renal (approximately 90%), fecal (approximately 10%)
Unchanged:
100%
Pharmacodynamics
OnsetOfAction:
Within minutes (IV); 30-60 minutes (oral)
PeakEffect:
1-2 hours (oral)
DurationOfAction:
Dependent on renal function and ongoing losses; effect lasts as long as supplementation continues and deficit is corrected.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high potassium levels, including:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Slow heartbeat
Chest pain or pressure
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Stomach pain or diarrhea
Upset stomach or vomiting
* Gas
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high potassium levels, including:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Slow heartbeat
Chest pain or pressure
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Stomach pain or diarrhea
Upset stomach or vomiting
* Gas
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Muscle weakness or paralysis
- Numbness or tingling in hands, feet, or lips
- Slow, fast, or irregular heartbeat
- Severe stomach pain, nausea, vomiting, or diarrhea
- Black, tarry, or bloody stools (signs of GI bleeding)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have high potassium levels, as this may affect the safety of taking this medication.
If you are currently taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene, as these may interact with this drug.
Please note that this is not an exhaustive list of all potential interactions. To ensure your safety, it is crucial to:
Inform your doctor and pharmacist about all medications you are taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
Discuss all your health problems with your doctor, as they may affect the safety and efficacy of this medication.
Never start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have high potassium levels, as this may affect the safety of taking this medication.
If you are currently taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene, as these may interact with this drug.
Please note that this is not an exhaustive list of all potential interactions. To ensure your safety, it is crucial to:
Inform your doctor and pharmacist about all medications you are taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins.
Discuss all your health problems with your doctor, as they may affect the safety and efficacy of this medication.
Never start, stop, or change the dose of any medication without first consulting your doctor to confirm it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount can increase the likelihood of adverse reactions. If you follow a low-sodium diet or use a salt substitute, consult with your doctor to discuss any potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to weigh the benefits and risks of this medication to both you and your baby to make an informed decision.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount can increase the likelihood of adverse reactions. If you follow a low-sodium diet or use a salt substitute, consult with your doctor to discuss any potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to weigh the benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Hyperkalemia (high potassium levels)
- Muscle weakness, flaccid paralysis
- Paresthesia (tingling or numbness)
- Bradycardia (slow heart rate)
- Hypotension (low blood pressure)
- Cardiac arrhythmias (e.g., peaked T waves, widened QRS, ventricular fibrillation, asystole)
What to Do:
Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Treatment may include IV calcium (for cardiac stability), IV insulin and glucose, sodium bicarbonate, diuretics, or dialysis.
Drug Interactions
Contraindicated Interactions
- Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) in patients with impaired renal function or severe hypokalemia
- Severe renal impairment (anuria, oliguria, acute renal failure, severe chronic renal failure)
Major Interactions
- ACE inhibitors (e.g., lisinopril, enalapril): Increased risk of hyperkalemia.
- Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan): Increased risk of hyperkalemia.
- Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride): Significant risk of severe hyperkalemia.
- NSAIDs (e.g., ibuprofen, naproxen): May reduce renal potassium excretion, increasing hyperkalemia risk.
- Cyclosporine, Tacrolimus: May increase serum potassium.
- Heparin: May cause hyperkalemia by inhibiting aldosterone secretion.
Moderate Interactions
- Digoxin: Hypokalemia increases digoxin toxicity; hyperkalemia can reduce digoxin efficacy.
- Beta-blockers (non-selective): May impair cellular uptake of potassium, leading to higher serum levels.
- Succinylcholine: May cause acute increase in serum potassium, especially in patients with pre-existing hyperkalemia or conditions predisposing to it.
Minor Interactions
- Laxatives (chronic use): May increase potassium loss, potentially counteracting supplementation.
Monitoring
Baseline Monitoring
Serum Potassium (K+)
Rationale: To establish baseline level and guide initial dosing.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Creatinine, GFR)
Rationale: Potassium is primarily renally excreted; impaired renal function significantly increases hyperkalemia risk.
Timing: Prior to initiation of therapy.
Electrocardiogram (ECG)
Rationale: If severe hypokalemia is present or suspected, to assess for cardiac arrhythmias.
Timing: Prior to initiation, especially if K+ < 2.5 mEq/L.
Routine Monitoring
Serum Potassium (K+)
Frequency: Daily initially for severe hypokalemia; then every 1-3 days until stable; then weekly to monthly for maintenance.
Target: 3.5-5.0 mEq/L
Action Threshold: Below 3.5 mEq/L (consider dose increase); Above 5.0 mEq/L (consider dose reduction/cessation); Above 5.5 mEq/L (urgent intervention for hyperkalemia).
Renal Function (BUN, Creatinine)
Frequency: Periodically, especially in patients with pre-existing renal impairment or those on concomitant medications affecting renal function.
Target: Normal limits
Action Threshold: Significant increase in BUN/Creatinine (re-evaluate potassium dosing).
Electrocardiogram (ECG)
Frequency: As clinically indicated, especially if potassium levels are rapidly changing or symptoms of hyperkalemia/hypokalemia develop.
Target: Normal sinus rhythm, no signs of hyperkalemia (peaked T waves, prolonged PR, widened QRS, absent P waves).
Action Threshold: ECG changes consistent with hyperkalemia (e.g., peaked T waves) require immediate intervention.
Symptom Monitoring
- Symptoms of hyperkalemia: muscle weakness, fatigue, paresthesia, bradycardia, irregular heartbeat, confusion.
- Symptoms of hypokalemia: muscle weakness, cramps, fatigue, constipation, palpitations, polyuria.
Special Patient Groups
Pregnancy
Potassium is an essential electrolyte. Supplementation is generally considered safe and necessary if a deficiency exists. Use during pregnancy should be based on clinical need and careful monitoring of serum potassium levels.
Trimester-Specific Risks:
First Trimester:
No known specific risks beyond general electrolyte balance.
Second Trimester:
No known specific risks beyond general electrolyte balance.
Third Trimester:
No known specific risks beyond general electrolyte balance.
Lactation
Potassium is a normal component of breast milk. Supplementation is generally considered safe during breastfeeding when clinically indicated, as it is an essential nutrient. Monitor infant for any unusual symptoms, though unlikely.
Infant Risk:
Low risk (L1)
Pediatric Use
Dosing must be carefully calculated based on body weight and severity of hypokalemia. Close monitoring of serum potassium and renal function is crucial due to higher risk of adverse effects with overdose. Liquid formulations are often preferred for ease of administration and dose titration.
Geriatric Use
Elderly patients are at increased risk for renal impairment, which can lead to potassium accumulation and hyperkalemia. Close monitoring of serum potassium and renal function is essential. Start with lower doses and titrate carefully.
Clinical Information
Clinical Pearls
- Always dilute liquid potassium chloride in water or juice to prevent esophageal and gastric irritation.
- Administer with food or immediately after meals to minimize GI upset.
- Never administer potassium chloride IV push or undiluted IV; rapid infusion can be fatal.
- Regular monitoring of serum potassium and renal function is critical, especially in patients with renal impairment or those on concomitant medications that affect potassium levels.
- Educate patients on symptoms of hyperkalemia and to seek immediate medical attention if they occur.
- Avoid potassium-containing salt substitutes unless specifically advised by a healthcare provider.
Alternative Therapies
- Potassium gluconate (oral)
- Potassium citrate (oral, also used for kidney stones)
- Dietary potassium intake (e.g., bananas, oranges, potatoes, leafy greens)
- Intravenous potassium chloride (for severe or symptomatic hypokalemia)
Cost & Coverage
Average Cost:
Varies widely, typically $10-$50 per 473 mL bottle (20 mEq/15 mL)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.